Individual
ERIC SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(918) 585-5548
Mailing address
3401 W GORE BLVD, LAWTON, OK 73505-6332
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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